Method and system for quantifying influence of big disease medical insurance policy adjustment on fund expenditure

A quantitative method and policy technology, applied in finance, instruments, data processing applications, etc., can solve problems such as difficult to accurately calculate the impact of medical insurance funds
CN110210984AInactive Publication Date: 2019-09-06PACIFIC MEDICAL HEALTH MANAGEMENT CO LTD
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Patent Information

Authority / Receiving Office
CN · China
Patent Type
Applications(China)
Current Assignee / Owner
PACIFIC MEDICAL HEALTH MANAGEMENT CO LTD
Publication Date
2019-09-06
Estimated Expiration
Not applicable · inactive patent

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Abstract

The invention discloses a method and a system for quantifying the influence of big disease medical insurance policy adjustment on fund expenditure. The method comprises the following steps of collecting samples: collecting Basic medical insurance reimbursement detail data or serious illness reimbursement detail data of all insured persons in the recent medical insurance year and a serious illnessmedical insurance policy wherein the serious illness medical insurance policy comprises an original serious illness medical insurance policy and a new serious illness medical insurance policy corresponding to the medical insurance year; counting data: counting the accumulated large-disease medical insurance reimbursement amount of all insured people in the medical insurance year based on the original large-disease medical insurance policy; and carrying out modeling prediction: calculating the accumulated amount and the policy influence factor of the serious medical insurance to be reimbursed of all insured people of the medical insurance year based on the new policy under the new serious medical insurance policy so as to predict the amount of the serious medical insurance to be reimbursedof the future new policy.
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Description

technical field

[0001] The present invention relates to the technical field of critical illness medical insurance policy adjustment, in particular to a method and system for quantifying the influence of critical illness medical insurance policy adjustment on fund expenditure. Background technique

[0002] With the establishment of the Medical Insurance Bureau and the continuous progress of medical reform, new medical insurance policies are frequently introduced, and the new policies have a huge impact on medical expenses. At the same time, the aging population and the continuous growth of per capita disposable income have increased medical expenses year by year, thus placing great pressure on the sustainable operation of medical insurance funds. By simulating the impact of medical insurance policies on the pooling fund and the amount of critical illness compensation under various scenarios, the adjustment of medical insurance policies is quantified, and the impact factors of...

Claims

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